Vardan S, Mookherjee S, Warner R, Smulyan H
JAMA. 1983 Nov 25;250(20):2807-13. doi: 10.1001/jama.250.20.2807.
Twenty-three patients older than 50 years, with systolic hypertension, underwent hemodynamic study. Cardiac output and stroke volume varied widely, with several high values. An elevated systemic vascular resistance, when considered as a function of the cardiac output, was the most prevalent hemodynamic abnormality. After administration of hydrochlorothiazide, 50 mg/day, for one month in 20 patients, 18 had a significant fall in BP, systemic vascular resistance, and stroke volume. After one year of continuous therapy, the hemodynamics, studied in 14 patients, did not change further. There were no clinical difficulties with carbohydrate intolerance, azotemia, hyperuricemia, or hypokalemia. No patient had symptoms of orthostatic hypotension or cardiac arrhythmias. Thus, thiazide therapy effectively and safely lowers the BP in most patients with systolic hypertension by reducing systemic vascular resistance.
23名年龄超过50岁的收缩期高血压患者接受了血流动力学研究。心输出量和每搏输出量变化很大，有几个高值。当将体循环血管阻力视为心输出量的函数时，升高是最常见的血流动力学异常。20名患者每天服用50mg氢氯噻嗪，持续1个月后，18名患者的血压、体循环血管阻力和每搏输出量显著下降。持续治疗一年后，对14名患者进行的血流动力学研究未进一步变化。未出现糖耐量异常、氮质血症、高尿酸血症或低钾血症的临床问题。没有患者出现体位性低血压或心律失常的症状。因此，噻嗪类药物治疗通过降低体循环血管阻力，在大多数收缩期高血压患者中有效且安全地降低血压。
